It is with great pleasure and excitement that I introduce Healthcare Risk Professionals of Tennessee (HRPT), a non-profit personal membership organization created to advance the development and role of professional practice of healthcare risk management. HRPT was conceived and

incorporated this month by a group of dedicated healthcare industry professionals interested in promoting effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking and interactions with leading healthcare organizations and government agencies.

HRPT was initiated by Angela Davis, Assistant Vice President – Southeast Regional Healthcare Manager at Ironshore Insurance Services. Angela graduated from Georgia State University, Magna Cum Laude, with a Business Administration degree focused in Enterprise Risk Management. She has been in the insurance industry for 14 years with a focus in medical malpractice for 10 years. She has seen many sides to healthcare risk management. For the past 12 years, Angela has been a licensed insurance agent in Georgia. Her past experience includes the Risk Management department of a multi-hospital health system in Georgia, and most recently she is an underwriter and regional manager for Ironshore, an innovative international specialty carrier.

Angela is a member of Georgia, North Carolina and Florida Societies for Healthcare Risk Management and participates in other groups from surgery centers to life science and long term care. She sees the benefit the groups bring in education, networking and resources to the healthcare sector. Having worked in Tennessee medical malpractice for the last 6 years, Angela is excited to be a part of the HRPT leadership founding team.

I am honored to also be a part of the founding membership and leadership and Angela and I are joined by Diane Moat, Director, Clinical Risk Management, Vanderbilt University Medical Center. Diane Moat has a nursing background in both Labor & Delivery, and Emergency Services. She graduated from Nashville School of Law in 2007, and was admitted to the Tennessee Bar in 2008. She’s worked at Vanderbilt for the past 23 years, with the last 11 years in Risk Management. Christie Schenk, Assistant Director, Clinical Risk Management and Anne Ussery, Director of Risk Operations both at Vanderbilt are also founders of HRPT.

Darlene Oxendine, Assistant Vice President, Risk Management

at Ardent Health Services also serves on the initial leadership team. Darlene has her undergraduate degree in Nursing and her Master’s degree in Healthcare Administration. She’s worked in the risk management field since 2009 in a variety of roles and with origins as a strong clinical background. She was a 2011 graduate of the American Hospital Association-National Patient Safety Foundation Patient Safety Leadership Fellowship. She currently holds certifications in Risk Management, Healthcare Safety and Professional in Patient Safety. She will serve on the American Society of Healthcare Risk Management Patient Safety Task Force beginning January 2017. Darlene is a member of the American Society of Healthcare Risk Management and the American Society of Professionals in Patient Safety. Prior to relocating to Tennessee, she was a member of the Kentucky Society for Healthcare Risk Management.

Kevin Gabhart joins the founding team and is the Senior Managing Director at Beecher Carlson, a full service insurance brokerage firm. Kevin is a senior member of the National Healthcare Practice for Beecher Carlson and leads the Healthcare Property and Casualty team. Prior to joining Beecher Carlson, Kevin served as President and Chief Operating Officer of Aon Risk Services, Inc. of Tennessee. He also led Aon’s Nashville Healthcare team, where he had direct involvement and responsibility for the design, evaluation, submission, marketing, placement and administration of complex property, casualty, executive protection and alternative risk programs. Kevin also spent several years with HCA, Inc. in its corporate Risk and Insurance Department. He also managed property and casualty claims for Liberty Mutual Insurance Company. Kevin is a member of RIMS, the risk management society and American Society for Healthcare Risk Management, and is a graduate of Georgetown College where he received his Bachelor of Science degree in Business Administration and Communications. He also earned a minor in Computer Science.

We are proud to form this valuable industry organization that will be ready to accept memberships on January 1, 2017. HRPT’s founding team has met several times to develop the mission and vison statements, by-laws and strategic plans.

HRPT’s stated Mission will include:

• Promoting alliances between risk, quality, legal, insurance, and regulatory organizations through exchange of information to influence healthcare risk culture in Tennessee

• Providing educational and networking opportunities to promote innovation and professional development

The hAT AdvAnTAge by Rebecca Adelman

INTRODUCING….HEALTHCARE RISK PROFESSIONALS OF TENNESSEE

Continued on page 4

Sent each Month to You aS a MeMber of the healthcare heroeS

Nursing & Assisted Living Facility Professional

N O V E M B E R 2 0 1 6I S S U E 11 , V O L U M E 6“ N E W S A N D V I E W S Y O U C A N R E A L L Y U S E ”

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Editor’s Note: We are pleased to welcome Beth Reigart as the newest columnist from Functional Pathways to the pages of Nursing & Assisted Living Facility Professional!

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis.

COPD affects an estimated 24 million individuals in the U.S., and over half of them have symptoms of COPD and do not know it. The COPD Foundation’s PRAXIS is a new initiative for healthcare providers, health systems administrators and policy makers created to improve COPD care across the continuum and reduce preventable hospital readmissions. The mission of the COPD Foundation’s PRAXIS is to Prevent and Reduce COPD Admissions through eXpertise and Innovation Sharing. The initiative aims to reduce the heavy burden of COPD exacerbations and hospital readmissions currently weighing on patients, families and providers through alignment with CMS Hospital Readmissions Reduction Program (HRRP) goals and the sharing of expertise and resources in ways which enable the proactive identification and elimination of gaps in COPD care.

The Cone Health System (Greensboro, NC) developed a method to improving outcomes for their COPD Patients. During the two-year study, their “Golden Card” COPD patient care plans were provided through a systemic quality improvement approach. Through the use of standardized protocols, the multidisciplinary team developed order sets, staff and patient education collaterals, patient empowerment, community partnerships, psycho-social support systems and timely follow up with physicians. In 2013, the Cone average COPD readmission rate was 87%. In 2015, their rate was reduced to 36%, representing an overall reduction of 70%.

Top 10 Skilled Therapy Interventions for COPD:1 Monitoring patient’s response to therapy via vital signs recording … before, during and after treatment2 Diaphragmatic, segmental and pursed lip breathing exercises3 Postural alignment in wheelchair and bed4 Manual therapy including treatment on the mat … bolsters, balls and wedges

5 Emphasis on postural alignment of head, neck and chest6 Strengthening of diaphragm and intercostal muscles7 Patient and caregiver education8 Energy conservation and work simplification techniques9 Standardized assessments10 Include SLP services as clinically indicated

Great Resourceshttp://www.copdfoundation.org/http://www.lung.org/

https://patienteducation.osumc.edu/Pages/Home.aspx

Please contact Beth at Functional Pathways for more information at 865.440.5447 or breigart@fprehab.com

Pathway to Rehabilitation

ExcellenceBy Beth Reigart

Clinical Operations Specialist

www.funct ionalpathways.com | 888.531.2204

• RELATIONSHIPS

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• SELF-IMPROVEMENT

• INNOVATION

• COMMITMENT

• PASSION

C O R E V A L U E S

The Leader in Educational and Risk Management Programs for Long-Term Care Professionals

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Carla Cheatham wrote a phenomenal blog series on this topic, http://carlacheatham.com/carlas-blog/. People go into healthcare to help others, to relieve suffering but what about those times when the grief and loss, the suffering, can’t be relieved? Where in the curriculum of becoming a nursing home CNA, nurse, social worker, physician, or department manager do staff learn how to bear witness to someone’s suffering and simply be present? Without teaching and mentoring, staff incorrectly shoulder those burdens themselves and feel that weight getting heavier each day. Couple that challenge with working unreasonably long days without adequate breaks, incredible pressure to do more with less, the disproportion of non-value added work and ongoing staffing challenges.

In 2015, various organizations began advocating that the Triple Aim - improving the patient experience of care, the health of populations and the cost of care - be expanded to a Quadruple Aim and include improving the life of healthcare providers, clinicians and staff. Focusing on the importance of staff finding joy and meaning in their work and improving the experience of providing care is integral to achieving the initial goals of the Triple Aim. “For a health system aspiring to the Triple Aim, fulfilling this precondition [of joy and meaning] must be a non-negotiable, enduring property of the system.” (2) I wonder what it’s going to take for us to realize we cannot keep going like we are, and therefore must change our course.

Talk with staff. Ask them if they are feeling fatigued or burnt out. But please, be ready to hear what they say and act on it, together. Create your own Quadruple Aim in your facility and see what creative ideas the team can achieve to reaffirm the reason everyone chose this profession. Staff will thank you. So will the residents and their families.

And I ask you, dear reader, are you tired? Do you yearn to breathe free?

Bodenheimer T, Sinsky C. “From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider.” Ann Fam Med 2014; 12(6): 573-576. doi: 10.1370/afm.1713

Sikka R, Morath J, Leape L. “The Quadruple Aim: care, health, cost and meaning in work.” BMJ Qual Saf doi:10.1136/bmjqs-2015-004160.

Paige Hector is a clinical educator, who gives workshops and seminars across the country on diverse topics including clinical operations for the inter-professional team, meaningful use of data, advance care planning, refusal of care, documentation and care plans. She is skilled at inspiring staff to critically evaluate their own organizations and then gives them the resources and guidance to make necessary changes. Contact Paige at 520-955-3387 or at paigehector@gmail.com plus you more discover more about her at www.paigeahead.com

On a recent trip to New York City with my husband and our 11 year old son, we stood in awe at the base of the magnificent Statue of Liberty. I contemplated the well-known quotation - Give me your tired, your poor, your huddled masses yearning to breathe free – and the thousands of people who have read those words over the years.

I’m going to take a risk here and share that I’ve been thinking how that expression - Give me your tired…yearning to breathe free - applies to nursing home staff. Let me explain

by sharing a few examples. This summer I attended a conference themed Self-Care for the Professional. Attendance? Paltry. A medical group that usually attends this conference said they just couldn’t justify sending their staff for such a “non-clinical” agenda.

A short time later, I received an email from a colleague at a nursing home outside of Phoenix who shared that she was working 10+ hour days while keeping her family going and caring for her aging parents. She’s tired, physically and emotionally. Go figure. A couple weeks ago I was talking with a medical director who shared that one of the nursing home companies he works with is now basing department managers’ raises on QAPI goal success. Their staff felt unappreciated and one person was so overwhelmed that she cried.

This isn’t a doom and gloom article but I don’t believe those examples are isolated events. Ignoring our individual needs to serve others has become a distorted expectation in this country, especially in the healthcare industry. We eat lunch while finishing our documentation; we forego using the restroom until it becomes so painful that we are forced to take a break. Healthy? No. But yet we continue to do it. The risks? Burnout and compassion fatigue. Adverse outcomes and patient dissatisfaction.

Burnout is associated with many undesirable conditions including loss of enthusiasm for work, feelings of cynicism, low sense of personal accomplishment and even suicidal ideation.Time that was spent at the bedside is now time spent at the computer screen. One study found that emergency room physicians completed 4,000 EHR clicks per day. Another study found that 37% of nursing home nurses report burnout which is associated with job dissatisfaction. Dissatisfaction and stress are associated with decreased patient safety. (1) Around and around we go. Yet, we demand longer and more strenuous days from staff, risking errors and mistakes in clinical judgment.

Compassion fatigue is different from burnout and is defined as a belief that we must take care of all of another person’s problems.

Getting on the Same Page by Paige Hector, LMSW

Keeping the Flame Burning

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Is It Possible That an Armed Gunman May Show Up at Your Facility?

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• Identifying and responding to ongoing and emerging issues and trends to strengthen the impact of the healthcare risk community

• Advocating for ethical healthcare risk management practices

• Collaborating with national and state professional associations such as ASHRM and the Tennessee Association for HealthCare Quality (TAHQ)

• Recognition as an influential leader in healthcare risk management

HRPT’s stated Vision will include:

• Providing webinars, resources and educational conferences available to members and non-members

• Serving as leaders for the healthcare risk community and facilitating peer collaboration

• Representing a geographical, professional, and experienced diverse group

• Creating and maintaining high level value added services for all members

• Maximizing effective communication and access to resources through interactive technology

HRPT will be governed by a strategic plan, by-laws and other governance materials.

The details of membership, dues and education agendas are being presented in January as part of the inaugural year. Ironshore and Hagwood Adelman Tipton, PC will host a reception for interested members in Nashville on January 11, 2017 from 4 pm to 6 pm. Look for more information and details to come!

Membership is open professionals whose employment responsibilities include healthcare risk management and patient safety or who have demonstrated a bona fide interest in the field of healthcare risk management and patient safety or who agree to support the mission, vision and code of professional responsibility of HRPT.

HRPT’s Members may include:

• Patient representatives, safety officers, quality improvement professionals, clinical patient care providers

• Attorneys who consistently represents the interest of healthcare providers Commercial insurance agents, insurance brokers, insurance company employees, risk management consultants or employees of a company that exists for the benefit of healthcare provider interests

• The organization will also consider student membership for those actively involved in the field of healthcare risk management or whose job responsibilities include healthcare risk management.

There will also be opportunities to participate in several committees including Nominating, Program, Membership, Media/Branding/Marketing, Sponsorship, Legislative and Historic.

Today’s health care industry faces many challenges and creates important opportunities for understanding, innovative problem-solving and collaborations. HRPT will offer members the unique and

comprehensive valued services to address, as a group, to elevate education and influence healthcare risk culture in Tennessee along with many other benefits.

We look forward to the growth and development of the Healthcare Risk Professionals of Tennessee and the important role HRPT will serve in the industry! For more information, please contact Angela Davis at Angela.Davis@ironshore.com.

Rebecca Adelman, PLLC, Esq. - Ms. Adelman is a founding shareholder of Hagwood Adelman Tipton, PC and practices in the firm’s Memphis, TN office. She is the chair of the firm’s Strategic Planning Committee and Women’s Rainmaker Mentoring Program. For over 25 years, Rebecca has concentrated her practice in insurance defense litigation representing national insurance carriers and self-insureds with a concentration in healthcare law. Please feel free to contact her at radelman@hatlawfirm.com or visit her website: www.rebeccaadelman.com.

The HAT Advantage continued from page 1

The Hagwood Adelman Tipton Memphis Office Has Moved!

Now Located at 647 S. Main Street

In the historic Railway Express Agency (REA) building in Central Station

Our telephone and fax numbers remain the same.

We look forward to serving you from our new location.

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Rebecca Adelman of Hagwood Adelman Tipton receives first Ethel Mitty Heart AwardPresented by The American Assisted Living Nurses Association during the annual national conference in Nashville, TN. Memphis, TN October 20, 2016-It is with great pride that Hagwood Adelman Tipton, PC announces Rebecca Adelman’s recognition as one of the first recipients of the newly founded Ethel Mitty Heart Award given by the American Assisted Living Nurses Association (AALNA) this past weekend. Ms. Adelman is a founder of the firm and manages the Memphis office.

Dr. Ethel Mitty provided distinguished service to nursing and senior living. Her successful career included being Research Associate and Adjunct Clinical Professor of Nursing in the College of Nursing at New York University (NYU), a Consultant in LTC at the Hartford Institute for Geriatric Nursing, College of Nursing, NYU, and 25 years as a Director of Nursing in Long-Term Care. As an AALNA board member, Ethel developed the association’s definitive statement regarding scope and standards of practice for assisted living nurses and her many lifetime achievements are well admired by her industry peers.

This accomplishment highlights Rebecca’s commitment to the AALNA though legal advising and education. Rebecca was very fond of Ethel and cites her as an inspiration. She was surprised with this honor before she gave her presentation at the AALNA National Conference this past weekend in Nashville. “To be recognized by the AALNA with an honor that embodies Ethel’s extraordinary and unique contributions to care for older adults is a highlight of my career. The AALNA has such an important and far-reaching impact on the health care industry. I am proud to be of service,” shares Rebecca.

Calvin Groeneweg, RN C-AL, Director of Risk Management with Northern California Presbyterian Homes and Services (NCPHS) and President of AALNA, states that Ms. Adelman is an inaugural recipient of this award due to “her leadership in healthcare and her tireless support of Assisted Living Nurses and works to improve their knowledge, as evidenced by her involvement in AALNA and its mission.” This award was given by the AALNA Board of Directors.

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